Scott Walkerhas long favored proposals that would reduce women’s access to birth control. In 1998, 1999 and 2001, Rep. Walker was the lead author of the “conscience bill,” which allowed doctors and pharmacists to refuse to prescribe and dispense birth control. He also supported a “personhood” amendment to the constitution that would outlaw some forms of birth control.

In his first budget as governor, Walker unsuccessfully attempted to repeal Wisconsin’s Contraceptive Equity law that requires employers to cover birth control in the same way as other prescriptions and preventive care. That budget would have also ended all funding of family planning clinics which offer contraceptive care (and do not offer abortions or abortion referrals), amounting to $1.9 million per year or $3.8 million over the biennium. This, too, was rejected by the Republican-led legislature.

Alan White, the Inspector General, was elevated to this position back in 2011 by Gov. Walker, with the announced goal of cracking down on fraud in state programs such as food assistance for the poor. The funding for the health planning agencies seems to fall into a very different category.

The two organizations targeted by White, the Wausau-based Family Planning Health Services, and the Oconto-based NEWCAP Community Health Services are part of Badger Care, and about 90 percent of the funding from the state actually comes from federal dollars. The organizations, as Golden reported, have long charged the same fee for services, as has every other family planning clinic in the state.

That includes Planned Parenthood of Wisconsin, whose public policy director Nicole Safer says the fee structure in fact was established by the state back in 2009 and was similar to that used in other states in the Midwest.

Milwaukee Journal Sentinel reporter Guy Boulton, in a recent story on the situation, posed these questions: “How could the clinics overbill for contraceptives and other prescription drugs when the state sets the payment rate? And if the state did pay the clinics too much for the drugs, how could it go undetected for five years?”

“The Department of Health Services,” he continued, “isn’t saying. The department declined to comment on the audits or explain how it pays family planning clinics for birth-control bills and other prescription drugs.

Back in November, when Golden first broke this story, White did comment, denying his audit was political and offering this statement: “This administration, this agency has put a great deal of effort into improving program integrity, and take it very seriously. And protecting the taxpayers of Wisconsin is their predominant responsibility.”

But White offered no explanation of how or why it made sense to change the reimbursement rate that all family planning clinics have been uniformly paid for five years. Safar suspects the clinics are being targeted for political reasons: “It’s something we’ve always been waiting for because we know that Walker does not support access to birth control services.”

White’s office claims that Family Planning Health Services Inc. overbilled Medicaid by $2.3 million, and NEWCAP Inc. by $1.2 million, from 2010 to 2011. But Molly Fuller, president and chief executive of Family Planning Health Services, told Boulton her organization has “following the instructions we have been given (from the state) and we’ve been following them for five years.”

Jennifer Waloway, a nurse practitioner who oversees the six family planning clinics in northeastern Wisconsin run by NEWCAP, says her organization would go out of business if the state sticks to the reimbursement rate it now wants to enforce. The repayment of $1.2 million the state demands from NEWCAP is nearly equal to its annual revenue of $1.2 million. Family Planning’s annual budget is about $3.4 million, compared to the $2.3 million the state demands it repay.

NEWCAP last year served 3,500 people in six counties in northeastern Wisconsin while Family Planning served about 6,000 people a year in 11 counties in north central Wisconsin. Both operate in areas officially designated to have shortages of health care professionals. The Medicaid funding they receive pays for their provision of contraceptives and family planning services, testing for cervical cancer, sexually transmitted diseases, HIV and pregnancy and treatment of sexually transmitted diseases. The clinics do not offer abortion or make abortion referrals.

“It would be a huge loss for these communities if they shut down,” says Safer. “These patients would have nowhere else to go. These are low income people who have no insurance or have some form of Badger Care.” Most of northern Wisconsin’s low income women would no longer have access to family planning services.

And if the Walker administration enforces this reimbursement rate for all other family planning clinics in the state?: “It would mean, quite frankly, that we would all close,” Hartung told Golden. “We’re all operating the same way” and getting paid the same reimbursement rate, she noted.

At issue is about $110 million a year of the state’s $7 billion Medicaid budget. But Safar cites numbers from the Guttmacher Institute, a sexual and reproductive health advocacy group, saying that for every $1 the government spends on family planning, it saves $7 by reducing unintended pregnancies and the spread of sexually transmitted diseases.

Diane Welsh, a former chief legal counsel to the Department of Health Services, is representing NEWCAP and Family Planning. Welsh responded to the state on the agencies’ behalf and told Boulton, “In the end, I’m very confident they will prevail.”

But it’s now been three months since she wrote the state and four months since the state issued its demand for repayment, and White’s office has yet to respond to Welsh. Meanwhile the clinics he targeted live with uncertainty regarding the law. This scared NEWCAP off from expanding its safety-net services this year, Waloway told Golden.

In his runs for governor, Walker was endorsed by Wisconsin Pro-Life, which opposes all forms of birth control and has championed the personhood amendment that Walker favored, which would ban some forms of birth control. Matt Sande, the group’s director of legislative affairs, told Lifesitenews.com that he hopes the OIG (White’s office) will do more audits of family planning agencies. “Those audits were very limited – in scope, in detail, in time frame,” he said. “What really needs to be done is that the OIG needs to do a comprehensive, thorough, robust audit of all family planning recipients, especially including Planned Parenthood of Wisconsin.”

I do so love taking the word of an advocacy group without a source to back up their claims. Still, I’m not going to say the underlying point is different, just that it’s always fun to rely on unsourced numbers from someone with a stake in the issue.

So were they actually overpaid from the stated reimbursement rate? What was the rate, and what was the payment? Or is that irrelevant to the story you’re telling?

Kyle, the maximum allowable fee for a monthly pack of birth control pills was set at $26.02 by the state in 2009, and has been what all clinics charge. Now the state is saying a lower price must be charged, though the exact amount is unclear.
As to accepting the word of advocacy groups, the state department making this decision has declined to answer questions, as I noted. The story could certainly be more complete if they chose to do so.

Not everyone sees being rabidly against the killing of unborn babies to be a bad thing. But I’m one of the few people that’s mostly neutral on that issue. I have no doubt that some find it easy to believe that the unchecked criminal Walker would bully innocent non-profits out of business. All I’m trying to ask is if there was an actual overpayment. It’s so sad when it’s a for birth-control, but people on this site (and others) would be screaming about Walker’s cronyism if a business owed 7 figures in back taxes and the state declined to collect it.

I need to remember to hit refresh before submitting a comment if I get pulled away…

So it looks like they were charging Medicaid the maximum amount allowed by law, even if that amount exceeding their costs for the drugs, plus the allowed dispensing fee. So they did overcharge by using the greater of two numbers when they should have used the lesser of two numbers. That answers my question. Doesn’t fit well with the persecution story though.

If nothing else, this story exposes some of the critical flaws of the Medicaid program. The fact is, even if we take the clinics word for it that the state agreed to “reimburse” far more than the actual cost of the pills, all that did was mask the funding flaws in the system. The clinics say they can only exist because of the over payments on the BC.

Medicaid was never designed to financially support an entire healthcare system. The fundamental idea behind it is that it would cover the incremental cost of adding a few low income patients to the normal course of operations. Most of the payment burden fell on the insured patients and their insurance companies.

This is one of the very reasons I cited when discussing why it was a good thing Walker was able to move some people to the insurance exchanges instead of accepting federal money for expanding Badgercare.

Anyway, I don’t have all the info or evidence to know whether the state really agreed to “reimburse” two to three times what the clinics actually paid for the birth control. Either way, this system is severely flawed.

Bruce, your short take (and really the entire article) makes it seem like the DHS is up to no good and targeting these groups. The DHS already responded to that claim and showed the data of their open audits, revealing no targeting of family planning clinics.

Hartung, Welsh and Safer were all involved when the state set the reimbursement rate back in 2009 and all agree on the rate that was established. And according to the family planning council that oversees all the state clinics, they all have charged that rate since. Meanwhile, the state has never offered any evidence that this was not the rate set back in 2009 and followed since. Should White ever decide to respond to the press to make this point, that would make a good story. But he’s had months to do so and hasn’t.
Whether the state should revisit how it pays for this service is a valid policy question, but to establish a new policy via an audit would be an unusual way to proceed.

That is funniest headline I have ever seen, Bruce, thanks for the laugh. I asked him to intro law about pharamcists not to have to do anything that they think is morally bankrupt and in some cases pills can be used for abortions. most pharmacy chains allow pharmacists to avoid doing that. Nurses, doctors do not have to assist in abortions according to law.
No one has any interest in stopping women from using BC. I have dispensed hundreds of thousands in my lifetime. Oppostion to PPH lies in their back ground of Eugenics, that nutty woman, Sanger, who wanted to wipe out black people. PPH is responsible for killing millions of black babies. That is what we, Conservatives are opposed. When the govt. sanctions killing of babies especially those of minorities, they are morally bankrupt, it must be stopped. No one wants women of any race not to have BC pills. Rant on guys you are really finny.

Abortions make up a tiny, tiny percentage of the work Planned Parenthood does. They provide vital health care services. Shutting them all down for good would not be a good thing. Plus, Sanger has been dead for how long now?

So what would pharmacists be allowed to say is morally bankrupt to them? Anything they wanted? Is there any line?

PMD, boy are you full of crap, PPH does million or so abortions yearly, they are abortion machine very little other things except hand out BC pills. Pharmacists , nurses, doctors would not have to participate in abortions or dispense abortifacients like RU286 which is really bad drug. Do some research once, you are all opinion and no facts.

As we stray further from topic… I’d like to put PMD’s “3 percent” comment in perspective. That’s 3 percent of all SERVICES. One woman getting an abortion probably has numerous “services” during several visits. So 1 woman, 1 baby, 1 abortion, but maybe 5 services.

As you can find from any of the fact checker websites, more than 1 in 10 women served by PPH receives an abortion.

In the end, any funds PPH receives for non-abortion services is only subsidizing their abortion operations.

Bruce, how about some Prilosec to go with all the indigestible facts? Couldn’t you distill it a little clearer? Or is the point to obfuscate by layering desultory and tangential facts, asking questions to leave us pondering while you slather on a few more facts?

Here are some interesting facts I did not see: How does the state calculate its reimbursement rate? Would be nice to know if it is a percent over clinic cost or based on the state’s cost or a manufacturer’s price list. How much does the clinic profit on various birth control or family planning items?

Those unanswered Gee Bulltoan questions: “How could the clinics overbill for contraceptives and other prescription drugs when the state sets the payment rate? And if the state did pay the clinics too much for the drugs, how could it go undetected for five years?”

Isn’t anyone going to attempt an answer?

They could overbill by refilling too often, filling Rx with generics and billing for name-brand, billing for phantom or underage patients, billing for meds they did not dispense. I did not read Golden’s piece. Did either of you flat out ask providers if they were billing deceptively or fraudulently? It’s not clear from reading your piece that you understand front to back the billing process. We’re just supposed to believe you do. And if you do, then you should be able to offer some explanation for Boulton’s second question.

“They’re penetrating the bureaucracy, Bob!”

WOUld be nice if you saved some of your noble skepticism for your friends as well as Walker and Republicans.

I’m glad my old boss stayed out of social conservatism. I’d like to believe Walker just feels, as I do, that folks should pay for their own family planning. But I suspect you’re right, there is some old fashioned finger-wagging and Bible-thumping behind it. I’m sure Madame Gaylor is cheering you on.

Next time, I hope you’d leave it in the copper pot until you got it distilled down to 800 words.

PPH is abortion mill, that is their principle service.
As for the billing. State sets rate, puts in the costs based on present costs, adds on a fee and the computer splits it out. Someone has screwed up. The computers are supposed to calculate the cost plus fee and what the company bills is meaningless. As for refills the computers calculate that, when they send it in. You cannot fill 30 pills: directions one daily, every ten days, it will get kicked back. Fault here lies with the state and its computers. No one can just decide to screw PPH. Their computer sends billing to the state computer.. Humans do not calculate anything but garbage in garbage out. bob Dohnal, RPh I billed millions to the state over the last 50 years.

WCD that just isn’t true. You keep condescendingly telling others to use facts and not opinions, but you don’t practice what you preach. You’re a massive hypocrite. Be pro-life and anti-PPH all you want, but don’t be a blatant liar. Abortion is 3% of PPH services. 16% is cancer screening and prevention. 35% is STD testing for men and women. 35% is contraception. In no way can 3% of something be a “principle service.”

“Also, WCD, do you believe making abortion illegal will completely end abortion?”

Not to defend WCD, but the logic you’re implying here is really poor. Making murder illegal didn’t end murder, so I suppose we shouldn’t have tried? What laws are allowed to stand when put to this test?

Kyle a day just wouldn’t be complete without your quibbles and nitpicks. I so look forward to them.

I don’t believe abortion is murder, and I’d like to know if people like WCD believe that making abortion illegal will end abortion, and if society benefits from criminalizing and imprisoning people for it. Don’t like the logic, too bad. Carry on and quibble elsewhere.

I never said you thought abortion was murder. Murder of born people is illegal, but it happens. Society benefits from criminalizing this behavior. Rape (of both people and animals) is illegal, but it happens. Society benefits from criminalizing this as well.

If I wanted to quibble, I’d have asked why society makes men pay child support for women’s “health issues” that they chose not to deal with.

Too funny. People would rather fund an entire lifetime of costs relating to an unplanned pregnancy rather then saving the money by providing family planning up front. All one needs to do is look at places like India, Brazil, and Bangladesh as proof that people, regardless of economics, will continue to produce children even if it is against their economic best interests. I guess it isn’t too far fetched though to believe that most people who are against family planning probably couldn’t point to one of these countries on a map.

All I’m saying is pick a side. Either a fetus is no different than HPV, a woman’s health issue that’s between her and her doctor to deal with, that she could have taken steps to prevent but didn’t (though that choice is also between her and her doctor). Or it’s a person that the father should support and we should think twice about before we “terminate” it.

And everyone knows that all those countries are on the island of Madagascar where Ebola and cartoon animals come from.

No making abortion illegal will not stop abortions. I have worked hard to make abortions gone by convincing people that babies are people and the Right to Life is paramount. When we slide down the slope of placing life and garbage in the same basket we all suffer.
There is nothing so beautiful as a baby, no mater what the color or ethnicity.

Coat hangers and black market practitioners are a tradition to be cherished, eh?

Asking to pick a side ignores the horrible fact that abortions were practiced for thousands of years by people unequipped to do so. The lesser evil is to allow licensed medical professionals to provide the procedure only after birth control and counseling is readily and easily accessible. People who focus on the definition of life ignore the dirty truth that the definition doesn’t matter at that point to people in desperate situations.

It seems the conservative answer is always based on a simple outlook. Cutting off government support of any social service will somehow magically make the ugly aspects of humanity disappear.

WCD, do you think pro-life groups focus enough on adoption reform? I feel like that’s an issue that often goes ignored. My sister and her husband went through hell trying to adopt, and while I am far from an expert, it sure seems to me like adoption reform is needed in this state.

WCD, if you carried that compassion over to when the “babies” become less adorable and need education, medical care, or face rehabilitation, I’d take you a bit seriously about your efforts to “make abortions gone.”

Michlig, where do you dopey people come from? completely ignorant. since 1974 I have campigned to fix MPS, break it up. The Left has run the schools into the ground for 40 years while they push for street cars and Arenas for billionaires. They have ruined Milwaukee. I have spent 40 year ministering health to people in rehab, nursing homes. People like you: filthy disgusting.
Bob Dohnal, Clinical Pharmacist, 40 years. I have seen the result of the drugs pushed by the Left. Pot is disastrous to people. Adoption reform is paramount. I have five kids, 3 special forces, a doctor and a manager for lauren. I wish I had had ten.

I didn’t say that choice A was solely the woman’s fault. It’s not solely the woman’s fault when an STD is passed either. But the woman gets a choice and the man doesn’t. Unless you’re saying that the man got a choice to have sex or not and the woman didn’t. But working under the assumption that occasionally, sex is consentual, only a woman gets to chose how to deal with the “problem”.

If your defense of abortion is that some of these children would lead rough lives, then logically it should be fine to “abort” them after they’ve been born. Same child. Same rough future. Same benefit to society.

How did a discussion about what the proper way to reimburse clinics for BC turn into a debate about abortion? Or is this an admission that funding some “family planning” clinics through other programs, such as the BC reimbursement rate, helps to keep the lights on and suction machines running for the clinics that provide abortions. I suppose if they succeed in forcing these clinics to return the money, the abortion clinics are next.

I’m ok with public funding for BC. I realize it’s a small investment to prevent the challenges and expense of unwanted pregnancies. However, I don’t support using those programs to divert funds that will now go towards abortion practices.

And PMD, I agree the adoption process needs a major overhaul. It would be in the interests of both choice and life supporters to get behind that idea. One of the things PPH could do is ramp up their adoption referrals and actually help people through the process. Instead of 90+ percent of their pregnancy services being abortions and abortion related, perhaps they could invest more in helping with the adoption process.

John Michlig, I can’t believe I’m defending WCD… but I will say this. Regardless of almost any topic on Urban Milwaukee, he will spout off a lengthy diatribe about schools, healthcare, and crime. Usually it has no bearing on the topic at hand what so ever and is extremely annoying. However, in this particular case, since you called him out for not caring about those things, it seems rather fitting. The irony of it made me laugh… so I had to bring it up.

It’s been a long time since I’ve looked up the numbers, but adoption services made up something like 5% of their pregnancy services vs over 90 for abortion. Plus you’ve seen many a sensationalized undercover video of the clinics basically outright pushing abortion. Sometimes tells me, even if exaggerated, there is room for improvement.

I’m surprised you’ve never seen anything from the pro-life side regarding adoption reform. It’s a fairly regular topic. Maybe it’s just not as apparent because that discussion isn’t usually done in an adversarial way to pro-choice groups so the message isn’t reaching people who are not normally exposed to pro-life sources unless it’s in a debate.

I made no comment as to whether or not I thought abortion was right. I pointed out that whether or not I agree with the practice is immaterial because it will always exist. Desperate people do desperate things, and I would rather we make it as easily as possible to prevent pregnancies. Preventing inception is far easier and cheaper then tax payers picking up the costs of trying to save a mothers life after it was endangered during a black market abortion. The other way of looking at it is an unwanted pregnancy then carrying over into a life ruined due to neglect and inability to provide stable parentage. Abortions should be incredibly rare, but exist in part due to poor education and access to birth control.

And Andy, anyone can see that the reimbursement issue is a veiled attempt at cutting the funding completely for these programs because a large percent of the population is unable to empathize with people who have very different backgrounds and realities.

“Wisconsin Conservative Digest ,” I am addressing (indicting) an ideology, not a person. It appears that Bob Dohnal has, to say the least, introduced a level of behavioral nuance that is refreshing but, sadly, rare. If Bob Dohnal carries his conviction forward as per his description, then thumbs -up.

“And Andy, anyone can see that the reimbursement issue is a veiled attempt at cutting the funding completely for these programs because a large percent of the population is unable to empathize with people who have very different backgrounds and realities.”

Totally agree. It’s interesting to see what happens when the issue hits close to home for people of means. I have an extremely rich, pro-life relative. When their daughter got pregnant as a teenager, they paid for a quick abortion. So it was OK for their daughter, but not for other people’s.

“And Andy, anyone can see that the reimbursement issue is a veiled attempt at cutting the funding completely for these programs because a large percent of the population is unable to empathize with people who have very different backgrounds and realities.”

If this is so obvious, was Milwaukee’s day care scandal also just a failure to empathize with people of different circumstances? It’s only millions of dollars, surely it’s not worth looking into fraud…

So PMD, your assumption regarding these two audits is that they’re gunning for the abortion clinics? Even though these clinics don’t perform these services and the data has shown that the DHS has not targeted these types of organizations any more than others?

Should we never audit non-profit organizations that receive state and federal funding?

I think the only question here is why/how the reimbursement rate for BC and other services are so out of whack and why there is no clear policy on some of these items.

Walker has opposed some measures that affected birth control in the past.
There’s a billing dispute with two clinics.
This is so bad for those clinics.
They billed the maximum rate, see it says right here it’s the max.
Completely ignore the issue about actual cost and allowed fees that this is based on.
But we help so many people, and in a way we actually save money.
Lawyer bashes the state and says they’ll win.
Find someone unrelated to the administration and the audit who wants to audit more clinics and get him to say he wants more clinics audited. This will be easier if you pick the spokesman for a group that wants all clinics audited.

I must have missed the actual evidence that this is the first step in a plot to shut down all clinics in the state.

The Left always judges these thing by their own rules, like using IRS to harass Conservatives, but fact is these audits are ongoing, and they are for MD’s, pharmacies and hospitals. They uncover a lot but mostt of them end up being the faults of the state and their computers.

let’s have a woman’s point of view. i would like the government at all levels to stay out of my personal medical decisions. birth control is usually the woman’s responsibility and we are very capable of making those decisions. we are strong enough to carry all the weight of any reproductive decision. walker can monitor his own wife’s birth control if he wants. let him leave mine and others alone.

Walker has nothing to do with any of this it is policy that has not changed for years and Walker cannot just change it for PPH. None of you understand the billing process. The bill goes in from provider to computer with the NDC number of the drug and the number of packets. The state takes the cost in its computers, adds on the professional fee and sends out check. You cannot bill $100 for something that costs $5 and expect to get it. it is all automatic, so the state for some reason was screwed up. It happened to me 30 years ago with my store. The state computers were screwed up, I was billing as directed and they paid some things that should have been set back a few days, they billed me, I appealed and won. PPH will do same, they will get paid only what they are supposed to get. PPH is trying to set this up as some kind of dumb plot by the Walkerr peope to screw them and that is impossible.

Dopey discussion guys. How about Miwaukee just named most naughtiest city, along with top ten on crime, top ten worst managed, worst schools, top ten worst poverty, heroin epidemic, human trafficking, Lousy Milwaukee cty. govt. abandoned houses, corruption high taxes, and really nutty leaders. While all of these problems swirl around we argue about an Arena.
Nobody wants to take away BC pills for women, especially single guys.

Roz, since your comments were about Walker “monitoring” your birth control the only conclusions a person can make is that either you use one of the clinics in the article and actually believe walker has anything to do with routine financial audits of the clinics you use, or that you didn’t read any more of this article than the misleading headline. I was sure you read it start to finish, which left me with the impression you went to these clinics. I stand corrected though, clearly the second option was correct all along.

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